tbuckley/cabot-search huggingface dataset:
Amiodarone Hepatotoxicity
Authors: Pil Soo Sung, Seung Kew Yoon
Journal: Hepatology (2011)

A 72-year-old Korean male was admitted because of sudden onset of abdominal distension. He had been treated with amiodarone 200 mg, felodipine 5 mg, hydrochlorothiazide 25 mg, and aspirin 100 mg per day for hypertension with atrial fibrillation for 5 years. Before starting medication, he had undergone ultrasonography of the liver and serum biochemical tests including liver chemistry and lipid profile, with all results being within the normal range. There was no evidence of hepatitis B and C, autoimmune hepatitis, or metabolic diseases such as nonalcoholic steatohepatitis, Wilson's disease, hemochromatosis, or α1-antitrypsin deficiency. In addition, he had no history of heavy alcohol consumption. CAD, cationic amphiphilic drug. Physical examination revealed massive ascites, peripheral edema, and splenomegaly. Liver chemistry tests were abnormal: serum albumin = 2.7 g/dL, total bilirubin = 2.3 mg/dL, aspartate aminotransferase = 317 U/L, alanine aminotransferase = 237 U/L, alkaline phosphatase = 137 U/L, gamma-glutamyl transpeptidase = 185 U/L, and international normalized ratio = 1.32. A transthoracic echocardiogram showed mild concentric left ventricular hypertrophy, ejection fraction of 73%, and mild pulmonary hypertension. A precontrast computed tomography scan showed a diffusely hyperdense liver and a large amount of ascites (Panel A). Transjugular liver biopsy demonstrated cirrhosis with polymorphonuclear infiltrate, Mallory bodies (arrows), and ballooning degeneration (arrowheads) (Panel B). Electron microscopy showed lysosomal myeloid bodies with dense deposits (asterisks) within hepatocytes (Panel C). On the basis of clinical history and histologic findings, amiodarone-induced liver cirrhosis was diagnosed, and the drug was replaced with another antiarrhythmic agent (propafenone). He was discharged with improved general condition with marked reduction of ascites. Although asymptomatic elevations of aminotransferases have been reported in up to 25% of the patients treated with long-term amiodarone therapy, symptomatic liver dysfunction has been reported to occur in fewer than 1% of these patients.1, 2 However, amiodarone-induced hepatitis can progress to cirrhosis, resulting in decompensated hepatic failure, although this rarely happens.1, 2 Amiodarone is one of the cationic amphiphilic drugs (CADs) that can cause phospholipidosis in liver.3 In this case, the findings demonstrating intralysosomal myelin figures and electron-dense material on electron microscopy are compatible with the findings of CAD-induced phospholipidosis.4 However, the functional consequences of phospholipidosis on cellular or tissue function have not been well explained. Rather, liver damage is considered to be caused by amiodarone-induced inhibition of mitochondrial β-oxidation.5
BLUE RUBBER BLEB NEVUS SYNDROME: ENDOSCOPIC TREATMENT WITH SCLEROSIS DURING DOUBLE BALLON ENTEROSCOPY IN A 9 YEAR OLD BOY
Authors: MC Malafaia, M Pioche, S Heissat, P Jacob, C Le Gall, M Ruiz, JC Saurin
Journal: Endoscopy (2019)

Blue rubber bleb nevus syndrome (BRBNS), also called Bean syndrome, is a rare disease associated with multiple venous malformations essentially in the skin and in the gastrointestinal tract (GIT) [1, 2]. Mostly it presents with anemia and the patients respond to supportive measures, but severe symptoms may be approached with surgical resection, endoscopic sclerosis, and laser photocoagulation [3, 4].
Chemical and Toxicological Characterization of Residential Oil Burner Emissions: I. Yields and Chemical Characterization of Extractables from Combustion of No. 2 Fuel Oil at Different Bacharach Smoke Numbers and Firing Cycles
Authors: Julie A. Leary, Klaus Biemann, Arthur L. Lafleur, Edward L. Kruzel, Gilles P. Prado, John P. Longwell, William A. Peters
Journal: Environmental Health Perspectives (1987)

Particulates and complex organic mixtures were sampled from the exhaust of a flame retention head residential oil burner combusting No. 2 fuel oil at three firing conditions: continuous at Bacharach Smoke No. 1, and cyclic (5 min on, 10 min off) at Smoke Nos. 1 and 5. The complex mixtures were recovered by successive Soxhlet extraction of filtered particulates and XAD-2 sorbent resin with methylene chloride (DCM) and then methanol (MeOH). Bacterial mutagenicity [see Paper II (8)] was found in the DCM extractables. Samples of DCM extracts from the two cyclic firing conditions and of the raw fuel were separated by gravity column chromatography on alumina. The resulting fractions were further characterized by a range of instrumental methods. Average yields of both unextracted particulates and of DCM extractables, normalized to a basis of per unit weight of fuel fired, were lower for continuous firing than for cyclic firing. For cyclic firing, decreasing the smoke number lowered the particulates emissions but only slightly reduced the average yield of DCM extractables. These and similar observations, here reported for two other oil burners, show that adjusting the burner to a lower smoke number has little effect on, or may actually increase, emissions of organic extractables of potential public health interest. Modifications of the burner firing cycle aimed at approaching continuous operation offer promise for reducing the amount of complex organic emissions. Unburned fuel accounted for roughly half of the DCM extractables from cyclic firing of the flame retention head burner at high and low smoke number. Large (i.e., greater than 3 ring) polycyclic aromatic hydrocarbons (PAH) were not observed in the DCM extractables from cyclic firing. However, nitroaromatics, typified by alkylated nitronaphthalenes, alkyl-nitrobiphenyls, and alkyl-nitrophenanthrenes were found in a minor subfraction containing a significant portion of the total mutagenic activity of the cyclic low smoke samples (8). Oxygen-containing PAH, typified by phenalene-1-one and its alkyl derivatives, are important mutagens from cyclic firing at high smoke conditions. Thus, oil burner effluents differ markedly from those of several other combustors, including the automotive diesel engine, where multiring PAH, typified by fluoranthene and alkylated phenanthrenes, account for a significant portion of the effluent mutagenicity. Implications for combustion and emissions source identification are discussed.
Controversy over Multiple Chemical Sensitivities
Authors: Gregory Simon
Journal: Annals of Internal Medicine (1994)

Letters1 February 1994Controversy over Multiple Chemical SensitivitiesGregory Simon, MD, MPH and William Daniell, MD, MPHGregory Simon, MD, MPHCenter for Health Studies; Seattle, WA 98101University of Washington; Seattle, WA 98195Search for more papers by this author and William Daniell, MD, MPHCenter for Health Studies; Seattle, WA 98101University of Washington; Seattle, WA 98195Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-3-199402010-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Drs. Margolick and Vogt raise questions about the comprehensiveness of the immunologic battery and the accuracy of specific laboratory techniques. We agree that more extensive and more technically sophisticated evaluation might be preferable. Our choice of immunologic evaluation was pragmatic: We used the exact “panel” of studies typically done by environmental physicians for assessment of chemically sensitive patients and on which a diagnosis of multiple chemical sensitivity is often based. Although these data may have some limitations in the study of immunologic mechanisms, they clearly argue against the utility of immunologic assessment as currently practiced.We thank Dr. ... Author, Article, and Disclosure InformationAffiliations: Center for Health Studies; Seattle, WA 98101University of Washington; Seattle, WA 98195 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1994Volume 120, Issue 3Page: 249-251KeywordsChemical analysisDisabilitiesPrevention, policy, and public healthResearch grantsResearch laboratories ePublished: 15 August 2000 Issue Published: 1 February 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Cerebral blood flow autoregulation and transcranial doppler sonography in patients with cirrhosis*1
Authors: F LARSEN
Journal: Hepatology (1995)

Impairment of cerebral blood flow (CBF) autoregulation may have serious implications for patients with cirrhosis if arterial hypotension occurs during coma, anesthesia, bleeding, or sepsis. In this study, CBF autoregulation was investigated in patients with cirrhosis with no or mild encephalopathy. Ten patients (median age, 45 years; range, 30 to 61 years) and six healthy volunteers (median age, 30 years; range, 21 to 61 years) were included. Catheters were placed in a radial artery and in the internal jugular vein. Baseline CBF was measured using single-photon emission computed tomography (SPECT) with concomitant measurements of cerebral arteriovenous oxygen content differences (AVDO2). CBF autoregulation was evaluated using the AVDO2 method and changes in mean flow velocity in the middle cerebral artery (Vmean) as determined by transcranial Doppler (TCD). Mean arterial pressure (MAP) was increased by 30 mm Hg by intravenous norepinephrine, and subsequently decreased by a combination of lower body negative pressure and ganglion blockade, whereas AVDO2 and Vmean were measured at each 5 mm Hg change in MAP. CBF was 61 (range, 45 to 78) mL 100 g−1 min−1 in patients with cirrhosis and 65 (range, 53 to 88) mL 100 g−1 min−1 in volunteers (not significant [NS]). There were no regional differences in CBF between the two groups. Arterial carbon dioxide tension was 31 (23 to 35) mm Hg in patients with cirrhosis and lower, compared with 36 (range, 34 to 37) mm Hg in the volunteers (P < .01). For evaluation of autoregulation, MAP was raised to 116 (range 100 to 145) and then decreased to 39 (range, 34 to 50) mm Hg. In 8 of 10 patients with cirrhosis, a lower limit of autoregulation of 74 (range 64 to 103) mm Hg was identified, similar to the value of 74 (range, 53 to 79) mm Hg in the controls. In the two remaining patients with cirrhosis, no lower limit could be established. A statistically significant correlation between Vmean and CBF below the lower limit of autoregulation was found in patients with cirrhosis (CBF = 22 + 0.75 · Vmean; r2 = .60; P < .005). CBF autoregulatory capacity seems generally preserved in patients with cirrhosis but the lower limit may be impaired in some patients and can be reliably evaluated using TCD sonography.
Cystinuria.
Authors: G. W. Frimpter
Journal: Annals of Internal Medicine (1963)

s1 April 1963Cystinuria.G. W. FrimpterG. W. FrimpterSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-58-4-740_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAmino acid excretion patterns were examined in 16 patients with cystinuria. Renal clearances of amino acids were studied in 4 patients. One of these demonstrated renal tubular secretion of amino acids. All patients with cystinuria excrete the asymmetrical disulfide L-cysteine and L-homocysteine. The origin of this substance from methionine was demonstrated by the administration of methionine-S35. At 1.25 hours after administration of methionine-S35, the urinary cystine and asymmetrical disulfide had a higher specific activity than later specimens. At first, the sulfur from the homocysteine and of the molecule had 9 times the specific activity of the cysteine sulfur, but later... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, N. Y. (BS) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1963Volume 58, Issue 4Page: 740-741KeywordsAmino acidsExcretionMethionine ePublished: 1 December 2008 Issue Published: 1 April 1963 PDF downloadLoading ...
Swallowing medication
Authors: J. A. Brown
Journal: JAMA (1982)

<h3>In Reply.—</h3> I welcome the opportunity to respond to Dr Weintraub's letter, since it illustrates so well the pitfalls of ignoring the clear clinical distinction between two sets of concepts. The disagreement here stems largely from confusing two separate topics. My topic was classic hysteria as recognized by Hippocrates, Briquet, Robins, Guze, and others. Weintraub's topic is what he calls "HCRs." Dr Weintraub imagines that the controversy surrounding hysteria is because psychiatrists, who see a relatively small proportion of hysterics, are the most prolific writers on the subject. In actuality, the controversy stems from the fact that some confuse a single symptom (conversion reaction) with a diagnosis, while others retain a classic, clinical-descriptive approach to a syndrome that has a defined natural history. The syndrome or disease of hysteria (Briquet's syndrome) has been clinically described and delimited from other diseases.<sup>1,2</sup>It is substantially represented in hospital and psychiatric clinic
Speed kills
Authors: E. Rose
Journal: BMJ (1990)

<h3>Abstract</h3> Antimicrobial resistance (AMR), largely driven by irrational use of antimicrobials, is a global, multi-faceted problem calling for a complete understanding of all contributory factors for effective containment. In conflict settings, war-wounds and malnutrition can combine with existing social determinants to increase demand for antibiotics, compounding irrational use. In this study, we focus on Yemen, a low-income country with active conflict for the last five years, and analyze the current status of awareness and stewardship efforts regarding AMR. We performed a survey of prescribers/physicians and pharmacists to describe perceptions of AMR prevalence, antibiotic use practices and stewardship in Yemen, supported by a non-systematic scoping literature review and a key informant interview. Participants (96%, n=57) reported a perceived high AMR prevalence rate. Prescribers (74%, 20/27) reported pressure to prescribe broad-spectrum antibiotics. In the majority of cases (81%, 22/27), Antimicrobial Sensitivity Tests (AST) were not performed to inform antibiotic choice. The main barrier to AST was cost. Most pharmacists (67%, 18/27) sold antibiotics without prescriptions. Amoxicillin (including amoxicillin-clavulanate) was the most-commonly prescribed (63%, 17/27) or dispensed (82%, 22/27) antibiotic. AST was rated the least important solution to AMR in Yemen. While there was awareness of a high AMR rate, stewardship is poor in Yemen. We note that barriers to the use of AST could be addressed through the deployment of low-cost AST kits. Compulsory continuing education emphasizing the use of AST to guide prescribing and patients’ awareness programs could help avoid irrational use.
Incisional recurrence of a cervical carcinoma. Report of a case
Authors: R. M. Greenlee
Journal: JAMA (1981)

METASTATIC carcinoma in an abdominal wall incision has been reported in cancers of the colon, bladder, and kidney.<sup>1</sup>We report the occurrence of metastatic nodules in the abdominal wall incision following operation for epidermoid carcinoma of the cervix. To our knowledge, this is the first reported case of such an event. <h3>Report of a Case</h3> A 41-year-old woman was first seen on Feb 5, 1979, complaining of intermenstrual bleeding for six days. Her past health and illnesses, including gynecologic history, were noncontributory. Physical examination revealed a weight of 72.3 kg, and normal pulse rate and respirations. Significant findings were limited to the pelvis. On the anterior lip of the cervix, a 4×5-cm exophytic, granular, friable lesion was found. The uterus and adnexa were normal on palpation. Parametria were soft and pliable. Rectal examination results were confirmatory. A biopsy specimen of the lesion revealed a moderately well-differentiated, nonkeratinizing squamous cell carcinoma
A Novel Sequential Treatment Utilizing CPX-351 as Salvage Chemotherapy Followed by a Reduced Intensity Conditioning Allogeneic Stem-Cell Transplantation for Patients with Refractory leukemia.
Authors: Usama Gergis, Ellen Ritchie, Gail J. Roboz, Joseph M. Scandura, Sebastian Mayer, Tomer M Mark, Tsiporah B. Shore, Usama Wissa, Eric J Feldman
Journal: Blood (2010)
Addiction medicine
Authors: J. E. Franklin
Journal: JAMA (1994)

Debate has intensified this year in political, media, and scientific circles regarding the success or failure of the "War on Drugs." Surgeon General Elders' call to study the matter this year has met with swift response. Two recent opinion articles, from an addiction medicine perspective, highlight the pros and cons of changing existing drug use laws.<sup>1,2</sup> Recent optimism regarding decreasing drug use in high school students has been tempered by a closer examination of the data and recent trends. According to the American Drug and Alcohol Survey, after a 5-year drop in drug use by high school students, there are early indications of a rise in the percentage of eighth graders who have tried marijuana and inhalants.<sup>3</sup>This survey echoes the National Survey of Secondary School Students, which also found statistically significant increases in the use of drugs in eighth graders.<sup>4</sup>These statistics do not include the
Die tuberkulösen Erkrankungen des Auges.
Journal: JAMA (1927)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Digestive Diseases
Authors: Howard M. Spiro
Journal: JAMA (1984)

The editors, both professors of medicine in the Digestive Disease Division at Emory University School of Medicine, Atlanta, had a good idea in dividing the material in their book into "low level" and "high level" resolution. They had an even better idea in their preface where they point out that textbooks sometimes oversimplify patient problems. Therefore, they planned to provide three levels of diagnostic investigation and certainty, viz, definite, probable, and circumstantial. I was intrigued with the potential of their analysis, but unfortunately what should have freed their writers turns out to be another kind of straitjacket. For example, under giardiasis, circumstantial evidence is a history of diarrhea in a patient who has recently returned from an endemic area; demonstration of the parasite in the stool is considered "only probable" evidence; whereas "definitive" evidence is "the demonstration of<i>Giardia lamblia</i>in the stool or on an aspirate or mucosal biopsy."
Parkinson's Disease and Amantadine Hydrochloride
Journal: JAMA (1969)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract 324: RNAi Inhibition of Phosphodiesterase 1A Prevents Cold-Induced Hypertension and Cardiac Hypertrophy
Authors: Zhongjie Sun
Journal: Circulation (2008)

The calcium/calmodulin-dependent phosphodiesterase 1A (PDE1A) hydrolyzes the intracellular second messengers cAMP and cGMP, which are known to play an important role in regulating vascular tone and smooth muscle cell (VSMC) proliferation. Intermittent exposure to cold (6 hr/day) results in hypertension and cardiac hypertrophy. Interestingly, PDE1A expression was up-regulated in resistance arteries, kidneys and heart of rats exposed to cold. We hypothesize that RNAi inhibition of PDE1A would attenuate cold-induced hypertension (CIH) and cardiac hypertrophy (CICH). We constructed PDE1A shRNA (PDE1A-shRNA) plasmid, Control-shRNA plasmid, and LacZ plasmid driven by a CMV promoter. AAV-2 was used for in vivo gene delivery. Five groups of rats were used to test the effect of in vivo inhibition of PDE1A expression on the development of CIH and CICH. Four groups received an intravenous injection of AAV.PDE1A-shRNA, AAV.Control-shRNA, AAV.LacZ, and PBS, respectively, before intermittent exposure to moderate cold temperature (5°C), while the last group received PBS and was kept at room temperature (25°C) as a control. Blood pressure (BP), monitored using a telemetry system, was increased significantly in all cold-exposed groups except the group treated with PDE1A-shRNA, indicating that PDE1A-shRNA prevented the development of CIH. PDE1A-shRNA enhanced hypothesive responses to acetylcholine in cold-exposed rats, indicating improved endothelial dysfunction. The MRI analysis indicated that the in vivo left ventricle wall thickness was also decreased significantly in the cold-exposed rats treated with PDE1A-shRNA. All animals were sacrificed at 10 weeks after gene delivery. PDE1A-shRNA significantly attenuated the cold-induced increases in heart weight, cardiomyocyte sizes, and vascular wall thickness. PDE1A-shRNA increased intracellular cGMP and cAMP levels and decreased VSMC cell proliferation and migration. PDE1A protein expression was significantly decreased, indicating effective silence of PDE1A gene. RNAi inhibition prevented CIH, CICH and cold-induced vascular dysfunction and hypertrophy. Thus, PDE1A plays a critical role in the pathogenesis of CIH and CICH.
Book Review
Authors: Harold L. Levitan, H. Becker, P. Körner, A. Stöffler, A. Sellschopp, H. Lüdeke, G. Haertel, Meredith Sabini, G. Foresti, M. Ferraro, P. Reithaar, C. Berlanda, M. Volpi, D. Drago, R. Cerutti, Mark J. Millan, Hinderk M. Emrich, S. Zepf, R. Liedtke, U. Berns, M. Arnold, C. Hartmann, C. Wagner, Jerald F. Dirks, Shawn K. Robinson, Debra L. Dirks
Journal: Psychotherapy and Psychosomatics (1981)